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Benchmarks in Clinical Productivity: A National Comprehensive Cancer Network Survey

Fox Chase Cancer Center, Philadelphia, PA; Fred Hutchinson Cancer Research Center, Seattle, WA; H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, Tampa, FL; Stanford Hospital and Clinics, Stanford, CA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD; University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; University of Washington, Seattle, WA; Roswell Park Cancer Institute, Buffalo, NY; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; Dana-Farber Cancer Institute, Boston, MA; Comprehensive Cancer Center–Arthur G. James Cancer Hospital; Richard J. Solove Research Institute, The Ohio State University, Columbus, OH; and the University of Nebraska Medical Center, Omaha, NE

Corresponding author: F. Marc Stewart, MD, Fred Hutchinson Cancer Research Center, University of Washington, 825 Eastlake Ave E, Mail Stop G4–810, Seattle, WA 98109, fstewart{at}seattlecca.org

PURPOSE: Oncologists in academic cancer centers usually generate professional fees that are insufficient to cover salaries and other expenses, despite significant clinical activity; therefore, supplemental funding is frequently required in order to support competitive levels of physician compensation. Relative value units (RVUs) allow comparisons of productivity across institutions and practice locations and provide a reasonable point of reference on which funding decisions can be based.

METHODS: We reviewed the clinical productivity and other characteristics of oncology physicians practicing in 13 major academic cancer institutions with membership or shared membership in the National Comprehensive Cancer Network (NCCN). The objectives of this study were to develop tools that would lead to better-informed decision making regarding practice management and physician deployment in comprehensive cancer centers and to determine benchmarks of productivity using RVUs accrued by physicians at each institution. Three hundred fifty-three individual physician practices across the 13 NCCN institutions in the survey provided data describing adult hematology/medical oncology and bone marrow/stem-cell transplantation programs. Data from the member institutions participating in the survey included all American Medical Association Current Procedural Terminology (CPT®) codes generated (billed) by each physician during each organization's fiscal year 2003 as a measure of actual clinical productivity. Physician characteristic data included specialty, clinical full-time equivalent (CFTE) status, faculty rank, faculty track, number of years of experience, and total salary by funding source. The average adult hematologist/medical oncologist in our sample would produce 3,745 RVUs if he/she worked full-time as a clinician (100% CFTE), compared with 4,506 RVUs for a 100% CFTE transplant oncologist.

RESULTS AND CONCLUSION: Our results suggest specific clinical productivity targets for academic oncologists and provide a methodology for analyzing potential factors associated with clinical productivity and developing clinical productivity targets specific for physicians with a mix of research, administrative, teaching, and clinical salary support.

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